Background

To encourage the rational prescribing of biologics, payers across Europe have experimented with the implementation of benefit-sharing programs. Benefit-sharing programs are incentive programs that promote the use of ‘best-value’ off-patent biologics and biosimilars by driving changes in prescribing practices. The aim of these programs is to generate savings that can be shared among stakeholders involved (e.g. health authorities/payers, health care professionals, hospital managers/administration) and are generally used to improve the quality of health care and to increase patients’ access to innovative services and medicines. However, the scarcity of information concerning the design, implementation and outcomes of benefit-sharing programs limits the transfer of knowledge to institutions aiming to adopt these types of incentive schemes in the future.

Objective

The aim of our study was to map benefit-sharing experiences across Europe, to compare their design and implementation characteristics and to assess the impact of the different benefit-sharing strategies on the use of ‘best-value’ biologics.

Method

Our approach was based on a literature review and on semi-structured interviews with payers/insurers, regulators, health care professionals and industry representatives.

Results

Our analysis revealed variable design characteristics for benefit-sharing programs, depending on the organization of the health care system, the specific timeframe, the care setting and the policy environment. All these aspects can influence the robustness of benefit-sharing initiatives and their potential to stay in effect over time. We also noted a generalized lack of transparency regarding the distribution of savings and how they are reinvested. This lack of transparency has raised questions on how to optimally implement benefit-sharing in the future.

Conclusions

To realize the full potential of benefit-sharing programs, we identify the importance of (i) setting up and timely monitoring success indicators for these programs; (ii) including quality of care and access to care parameters as success indicators; (iii) establishing clear pathways for the transparent redistribution/reinvestment of savings and (iv) transparently communicating with patients about the outcomes of benefit-sharing programs.

中文翻译：

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欧洲生物制品利益共享计划设计和实施的定性分析

背景

为了鼓励生物制剂的合理处方，欧洲各地的支付者已经尝试实施利益分享计划。利益分享计划是激励计划，通过推动处方实践的改变来促进“最佳价值”非专利生物制剂和生物仿制药的使用。这些计划的目的是产生可以在相关利益相关者（例如卫生当局/付款人、卫生保健专业人员、医院管理人员/行政人员）之间共享的储蓄，通常用于提高卫生保健质量和增加患者获得医疗服务的机会。创新服务和药物。然而，关于设计的信息稀缺，

客观的

我们研究的目的是绘制整个欧洲的利益共享经验，比较它们的设计和实施特点，并评估不同利益共享策略对使用“最佳价值”生物制剂的影响。

方法

我们的方法基于文献回顾和对付款人/保险公司、监管机构、医疗保健专业人员和行业代表的半结构化访谈。

结果

我们的分析揭示了利益共享计划的可变设计特征，具体取决于医疗保健系统的组织、具体时间框架、医疗环境和政策环境。所有这些方面都会影响惠益分享计划的稳健性及其长期有效的潜力。我们还注意到，储蓄分配及其再投资方式普遍缺乏透明度。这种缺乏透明度引发了关于如何在未来以最佳方式实施惠益分享的问题。

结论

为了充分发挥惠益分享计划的潜力，我们确定了以下几点的重要性：(i) 为这些计划建立并及时监测成功指标；(ii) 将护理质量和获得护理参数作为成功指标；(iii) 为储蓄的透明再分配/再投资建立明确的途径，以及 (iv) 与患者就利益共享计划的结果进行透明沟通。